Infections of the Beard Region

\\HEN One iS Co 01SUited bV a HaIll\xhohias at skiti liscase, onl t1c bic1;I region1 0o11n, onle imimediately thiniks(of i hi-cc (1diCeases inpetigo coiltagiusa, SVtusiS, and rilig-woriml. All thlr-ee dliSeaISeS aeC C0 'It oios, and iax he ('ont racted at a barber's, henice the term 'd (firv shave,' tile okl termi for-rin worm of thle beard being "barber's itclh.' On tle other hand, it is mnorle frequent to fil(1 thies cliseases in men whilo shave themslv'eix-cs, and it is soIetiies plrOl)lo lalemtic w ll ilhelce the inifectioIn comes. In order to inake a (lehniltc dia-1no0sis, thlrt aie soe S0 cry inll)oprtanlt Clinical points which must be noted. First of all, lhox long has tlie dlisease been)presentt? InI imIplCi gO, thIC (1i1-<1t1ion is Ls ISlally g ivell of a lexx ilavs l11) to a week or txo; if it is ringwornl, a fexv wxeeks is uIuSall the historvy; xx li1-ras I patiet witli sv cosis savs that the disease has beeinll pli-sclt xxwiti IxacrhatiOils aild r'missionls foI' mllontlhs or years. Secondly, what is the tVpe of lesion olIe IcIs i cla case? 'lic cfoi e, I slhall attemiipt to describe briefly thiese thrieet' (liseases. Impetigo colntagiosa coiimellcic.s as a xesiciCe Which is Ip1odL(Cd I1li thle act iouI of streptococci WhiChll Iave gain(Id eltrailce to thle ep)iderllis thlroug h a sI light abrasionl ofteni durinlg or after sllavilig-. I'lle roof of the xvesicle, beilng-very thlill, sooll breaks, allowing clear serumlll to eXLxud, Calrlriilng streptococ(ci with it. \Ver sooll afterwards, the exudedi ser-ulll (Iries to for-mii broWnish1 or MIamber-Collurd cTrUsts, Which Oil removal leave raw, moist suLrfaC-es. Strp)totC(iti sl)rea(l to tle stiLrotiil(lin-skill, producing freslh lesionis, so thalt iii this \Vax anlld by shl.iavig, p.Irt oI the wxxhole of the beard regionallV be Afletd. After a xxcek or two, a typical piCtUre is seen of raw, oozilng surfaces ald various-size(d b)r-o\lli.Sl Crusts,-which appear to be simpl) stucLk onl the skill. Imlipetigo b)eilng a super-ficalI illfectioll, may not be absolutely coiitiile(d to tIle I)eard rgiionl, but mlax spr-ea(d to noll-hail)ilrts of the face andl neck or oin to tile ears. Ilie hairs aindl llhlir-follicles are Ilot as a 1-rCle all etcCLd unless the disease is complicated b)v sta phvlococci, whichl pro(ltduce pustular lesiolns. In the latter case, the patient is liable to be left with the illor-(ihronlicl disease, sycosis, after the iillpetigo lhas b)eenl curedi. As a rule, subjective symniptoilis are niot marked, itchinllg lilig …